Doctor Name: | EDWARD JONATHAN RICE |
NPI Number: | 1720196603 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | VP006172B |
Business Practice Address: | 3815 Gordon Hwy Harlem, GA - 308143616 |
Business Phone Number: | 7068302798 |
Business Fax Number: | |
Mailing Address: | 3815 Gordon Hwy, HARLEM |
State: | GA |
Postal Code: | 308143616 |
Phone Number: | 7068302798 |
Fax Number: | |
NPI Enumeration Date: | 08/29/2006 |
NPI Last Update Date: | 10/04/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | VP006172B |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |